Published Online
on May 5, 2005

A more recent version of this article appeared on June 1, 2005

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Submitted on January 14, 2005
Revised on February 24, 2005
Accepted on February 28, 2005

Steps After Stroke. Capturing Ambulatory Recovery

Marianne Shaughnessy PhD, CRNP^*; Kathleen M. Michael PhD, RN; John D. Sorkin MD, PhD; and Richard F. Macko MD

From the Baltimore VA Geriatrics Research, Education, and Clinical Center (GRECC; M.S., K.M.M., J.D.S., R.F.M.), Maryland; University of Maryland School of Nursing (M.S.), Baltimore; and University of Maryland School of Medicine (K.M.M., J.D.S., R.F.M.), Baltimore.

^* To whom correspondence should be addressed. E-mail: mshaughn{at}grecc.umaryland.edu.

Background and Purpose--Nearly two thirds of stroke survivors have deficits impairing ambulatory recovery. Conventional mobility outcome measures such as timed walks and functional independence measure (FIM) do not quantify free-living ambulatory behavior. This study compared step activity monitoring (SAM) with established instruments to assess ambulatory recovery across the outpatient subacute stroke rehabilitation phase.

Methods--We measured FIM mobility subscale, SAM-derived daily steps, Stroke Impact Scale (SIS) mobility scores, and timed walks in 11 subjects after discharge from inpatient rehabilitation and again 3 months later.

Results--Significant improvement was measured in free-living step activity (mean gain 80%; P=0.001) but not with timed walks (P=0.4), FIM (P=0.08), or SIS mobility scales (P=0.3).

Conclusions--Microprocessor-linked SAM is a sensitive indicator of ambulatory recovery that measures improvements not captured by other conventional outcome instruments.

Key words: outcome • stroke

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